Provider Demographics
NPI:1568402766
Name:BRYNIARSKI, JAMES HENRY (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HENRY
Last Name:BRYNIARSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2407
Mailing Address - Country:US
Mailing Address - Phone:773-586-9700
Mailing Address - Fax:773-586-0962
Practice Address - Street 1:6615 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2407
Practice Address - Country:US
Practice Address - Phone:773-586-9700
Practice Address - Fax:773-586-0962
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice